目的:研究唇侧倾斜的种植体轴是否会影响上颌骨前部即刻种植体置入和修复(IIPP)的临床结果。
方法:纳入上颌中切牙或上颌外侧切牙不可挽救的患者。在所有参与者中进行IIPP同时进行结缔组织移植(CTG)。在对照组中,牙槽的长轴与牙齿对齐,这确保了立即植入的目标是切牙边缘或未来修复的扣带。测试组的脊和牙齿的轴之间具有较大的角度。为了避免骨开窗,植入物倾斜放置在唇侧,并从未来修复的唇侧出现。进行口腔内扫描和锥形束计算机断层扫描,以记录基线和1年后的软组织和硬组织轮廓。软组织稳定性,骨重塑,评估并比较两组患者的粉红美学评分(PES)。
结果:39名参与者(19个测试和20个对照)完成了研究。手术后1年,面部中部牙龈缘迁移为0.85±0.37mm(测试)和0.81±0.33mm(对照),没有显著差异。口腔轮廓改变没有发现差异,线性脊减少,颊骨厚度,或PES分数。试验组比对照组显示出较薄的口腔软组织。
结论:当出现较大的牙脊角度时,唇侧倾斜的植入物,在IIPP中使用CTG避免颊脊开窗,短期内不会影响临床结局。
OBJECTIVE: To investigate whether a labially inclined implant axis compromises the clinical outcomes of immediate implant placement and provisionalization (IIPP) in the anterior maxilla.
METHODS: Patients with unsalvageable central or lateral maxillary incisors were enrolled. IIPP with simultaneous connective tissue graft (CTG) was performed in all participants. In the control group, the alveolar ridge had a long axis aligned with the tooth, which ensured that the immediate implant was aimed at the incisor edge or the cingulum of future restoration. The test group had a large angle between the axes of the ridge and tooth. To avoid bone fenestration, the implants were placed labially inclined and emerged from the labial side of future restoration. Intra-oral scanning and cone-beam computed tomography were performed to record soft and hard tissue profiles at baseline and 1 year later. Soft tissue stability, bone remodeling, and pink esthetic score (PES) were evaluated and compared between two groups.
RESULTS: Thirty-nine participants (19 tests and 20 controls) completed the
study. At 1-year post-surgery, the mid-facial gingival margin migrations were 0.85 ± 0.37 mm (test) and 0.81 ± 0.33 mm (control), without significant differences. No differences were identified in buccal profile alteration, linear ridge reduction, buccal bone thickness, or PES scores. The test group demonstrated thinner buccal soft tissue at the crestal level than the control group.
CONCLUSIONS: When large tooth-ridge angulation presented, labially inclined implant, avoiding buccal ridge fenestration in IIPP with CTG, did not compromise the clinical outcome in short term.